Hicks, Benjamin Matthew
Hicks, Benjamin Matthew is an individual health care provider with primary practice located at 7601 W Jefferson Blvd , Fort Wayne IN 46804-4133. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Trauma, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Trauma is his primary health care specialty. Hicks, Benjamin Matthew can be contacted via phone (260) 436-8686.Contact Information
Primary practice address
7601 W Jefferson Blvd
Fort Wayne IN 46804-4133
Phone: (260) 436-8686
Fax: (260) 436-8585
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Orthopaedic Trauma | 207XX0801X | 01046509A | Indiana |
Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 01046509A | Indiana |
Profile Details
NPI number | 1780687707 |
---|---|
LBN Legal business name | Hicks, Benjamin Matthew |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 23rd, 2005 |
Last updated | Nov 3rd, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1780687707 | NPPES |
Other | 00000089400 | ANTHEM | |
Other | 200032481 | ANTHEM | |
MEDICAID | 200089330A | ANTHEM |
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